18 December 2009

I got to work last night at eleven pm, to find two doctors and one PA sitting there playing with their fingers and staring at the ceiling. There were maybe five patients in the entire department. So I sent the other guys home. They were all scheduled to leave in the next couple of hours anyways.

Predictably, in the hour after they all left, nine patients registered, and I wound up seeing a grand total of 24 patients in the last six hours of my shift, including a head bleed, an emergent dialysis with potassium of nine, and a DKA. Never sat down to eat much less anything else.

Gaah. Of course it's my own fault for daring to send them home, and for bringing work in to do on the shift. Everybody knows that ER volume is directly proportionate to the amount of reading material you bring in!

The only silver lining is that the last patients were reasonably simple and I walked out of there thirty minutes after the end of my shift. I was so stupid from lack of sleep I could barely figure out how to get the keys into the ignition of my car.

2 comments:

In residency I always cringed when my attending chose to send some (other) residents home. The effects were so predictable -- like a big red button that said "for huge bolus of new patients, push here."

Isn't this to be expected? Illness in the community is probably pretty constant from hour-to-hour... If very few patients check in over a period of time, it seems pretty likely that over the next block of time that it will be disproportionately higher. Regression to the mean, or something like that...

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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